Levels of Care of Eating Disorder Treatment

Elisha: The levels of care of treatment reflect a continuum of care ranging from inpatient treatment, partial hospitalization programs, residential treatment, intensive outpatient, and outpatient treatment. The levels of care are highly individualized and take into account the patient's psychiatric functioning, including co-morbid disorders, nutritional status, medical status, availability of family support systems, suicidal behaviors, and geographic availability of treatment.

Eating disorder treatment requires a multi-disciplinary approach to treatment. An eating disorder cannot be treated in isolation. The primary members of the treatment team include the physician, dietitian and mental health professional. The physician's primary responsibility is to monitor medical status and assess for any medical complications. The primary role of the dietitian is to monitor meal plan, provide meal support, monitor weight and approach caloric intake. The mental health professional has the responsibility of assessing the underlying psychological factors that contributed to the eating disorder and also maintain the eating disorder. Family therapy is also an important component of treatment for adolescents and college students living at home.

One important thing to keep in mind is that the family is very often blamed for the individual's eating disorder. Please keep in mind that the family may contribute to the eating disorder or provide some stressors that contribute to the eating disorder; however, the family is not to blame. Through family therapy the family can learn to set appropriate boundaries and develop appropriate coping skills.

Patients move back and forth between the various levels of care depending on medical status, nutritional status and mental health stability. Although we follow very closely the American Psychiatric Association guidelines for level of care, the insurance companies are also afforded the opportunity to outline their own levels of care criteria. For instance, a patient may be in an inpatient level of care, however after a certain amount of days the insurance company decides to no longer fund that individual's treatment at this level of care. Therefore if the family is unable to afford for the individual to remain at that level of care, the individual may have to be stepped down to a lesser level of care.

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